| NPI | 1992147151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085004723) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057705) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2018-10-02 |